Provider Demographics
NPI:1205995222
Name:BODE, ANN M (APRN)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:BODE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7308 S 142ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-6804
Mailing Address - Country:US
Mailing Address - Phone:402-717-4200
Mailing Address - Fax:402-717-4231
Practice Address - Street 1:7308 S 142ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68138-6804
Practice Address - Country:US
Practice Address - Phone:402-717-4200
Practice Address - Fax:402-717-4231
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE32905163W00000X
NE110190363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse